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The aim of this study was to investigate the parlors’ throughput for dairy ewes and influencing factors in some European countries and in Greece. A great progress was done in this direction with the simultainous improvement of the animals’ milkability, the technological characteristics of milking machines and the technical knowledge provided to the farmers. Nowadays the average parlors’ throughput for the “Casse” system milking machines is 160-200 ewes/milker/h, while for the “Carrousel” type milking machines it is 200-280 ewes/milker/h. In the case of installation of the automatic cup removal system the parlors’ throughput ranges between 300-400 ewes/milker/h. In Greece, the average throughput for the “Casse” system parlors was found to range from 59 to 127 ewes/milker/h, while for the “Carrousel” type milking machines was found around 90-100 ewes/milker/h.

Background/Objectives: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with limited effective treatments, prompting the need for investigation of novel therapeutic approaches. Eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) have demonstrated potential anti-inflammatory properties, but their combined effects on UC have not been thoroughly investigated. This study aimed to evaluate the effect of the combined administration of EPA and GLA on clinical and histopathologic features of experimental UC models. Methods: Thirty-six male Wistar rats were randomized in three groups (DSS group, Ensure Plus group, and Oxepa group), with twelve rats in each group. Experimental colitis was induced by administrating dextran sulfate sodium (DSS) 8%. The DSS group received tap water, the Ensure Plus group was given a high caloric diet, and the Oxepa group received a special diet containing high levels of EPA and GLA. Disease activity index (DAI) and microscopic activity index (MAI) were measured. Inflammatory markers were calculated both in blood and large intestine, liver, spleen, and lung tissue samples. Neutrophil and macrophage populations were assessed with immunohistochemistry. Results: No significant differences in the DAI index were found between the groups, but the MAI revealed statistically significant differences ( p < 0.001). While no significant differences were observed in tumor necrosis factor-alpha (TNF-α) levels, interleukin-17 (IL-17) levels in the large intestine showed statistically significant differences ( p = 0.05), with the Ensure Plus and Oxepa groups displaying lower levels compared to the DSS group ( p = 0.021 and p = 0.043, respectively). Significant differences in neutrophil infiltration were found in both the large intestine ( p < 0.001) and lungs ( p = 0.002), with the Oxepa group showing fewer cells. Similarly, significant differences in macrophage infiltration were observed in the large intestine ( p = 0.038) and spleen ( p < 0.001), with the Oxepa group having lower macrophage counts. Conclusions: In conclusion, the combination of EPA and GLA demonstrates local anti-inflammatory effects and improves the histopathological outcomes in UC.

Background: Rectal prolapse (RP) predominantly affects women over the age of 50 and presents as mucosal, internal, or full thickness prolapse. Strangulated rectal prolapse requires immediate medical intervention, and surgical treatment options include both abdominal and perineal approaches. We aim to present a case series of perineal rectosigmoidectomy performed urgently due to strangulation and argue that Altemeier's procedure is the preferred method for treating strangulated rectal prolapse., Methods: Perineal rectosigmoidectomy, particularly Altemeier's procedure, is effective for incarcerated cases. Altemeier's procedure with diverting ileostomy was used in all three patients., Results: All patients were successfully treated, with no recurrence of prolapse and stool incontinence., Conclusions: Altemeier's procedure is ideal for the treatment of strangulated rectal prolapse.

Transposition of inferior vena cava, or, left-sided inferior vena cava (LS-IVC) is a rare clinical entity, in which the inferior vena cava ascends along the left side of the abdominal aorta. Literature contains mainly clinical case reports. Although it is usually not associated with clinical symptomatology, this anomaly should be detected during preoperative planning to avoid iatrogenic injuries intraoperatively. We present a case of left-sided inferior vena cava encountered during laparoscopic lymphadenectomy in a 45-year-old man with previous laparoscopic hemicolectomy due to colon adenocarcinoma. Preoperative CT abdomen revealed the left-sided location of infrarenal IVC and laparoscopic trans-peritoneal aortic lymphadenectomy was decided. Intraoperatively, transposition of inferior vena cava was confirmed in accordance with the CT findings. Resection of lymph node block was conducted with no complications and with minimal blood loss. The postoperative course was uneventful, and the patient was discharged from the hospital the day following surgery. In conclusion, transposition of the inferior vena cava, although rare, constitutes an anatomical variant that should be identified preoperatively to decrease intraoperative risks. Several anatomical variants have been associated with left-sided inferior vena cava., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Cytoreductive surgery (CRS), combined with hyperthermic intraperitoneal chemotherapy, has significantly improved survival outcomes in patients with peritoneal carcinomatosis from colorectal cancer (CRC). Regorafenib is an oral agent administered in patients with refractory metastatic CRC. Our aim was to investigate the outcomes of intraperitoneal administration of regorafenib for intraperitoneal chemotherapy (IPEC) or/and CRS in a rat model of colorectal peritoneal metastases regarding immunology and peritoneal cytology. A total of 24 rats were included. Twenty-eight days after carcinogenesis induction, rats were randomized into following groups: group A: control group; group B: CRS only; group C: IPEC only; and group D: CRS + IPEC. On day 56 after carcinogenesis, euthanasia and laparotomy were performed. Serum levels of interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) as well as peritoneal cytology were investigated. Groups B and D had statistically significant lower mean levels of IL-6 and TNF-α compared to groups A and C, but there was no significant difference between them. Both B and D groups presented a statistically significant difference regarding the rate of negative peritoneal cytology, when compared to the control group, but not to group C. In conclusion, regorafenib-based IPEC, combined with CRS, may constitute a promising tool against peritoneal carcinomatosis by altering the tumor microenvironment.

(1) Background: A surgical operation on an inflamed bowel is, diachronically, a challenge for the surgeon, especially for patients with inflammatory bowel disease. Adipose tissue-derived mesenchymal stromal cells are already in use in clinical settings for their anti-inflammatory properties. The rationale of the current study was to use AdMSCs in high-risk anastomoses to monitor if they attenuate inflammation and prevent anastomotic leak. (2) Methods: a total of 4 groups of rats were subjected to a surgical transection of the large intestine and primary anastomosis. In two groups, DSS 5% was administered for 7 days prior to the procedure, to induce acute intestinal inflammation. After the anastomosis, 5 × 10 6 autologous AdMSCs or an acellular solution was injected locally. Macroscopic evaluation, bursting pressure, hydroxyproline, and inflammatory cytokine expression were the parameters measured on the 8th post-operative day. (3) Results: Significantly less intra-abdominal complications, higher bursting pressures, and a decrease in pro-inflammatory markers were found in the groups that received AdMSCs. No difference in VEGF expression was observed on the 8th post-operative day. (4) Conclusions: AdMSCs attenuate inflammation in cases of acutely inflamed anastomosis.

Background: The use of prosthetic meshes in abdominal wall reconstruction is a well-established approach; however, in certain cases where a bowel resection coexists its application is disputed. Any underlying inflammatory process may augment adhesion formation which is a major postoperative complication. In this animal study, our aim was to investigate the effect of N-acetyl-l-cysteine (NAC) on adhesion formation and the expression of inflammatory markers when a mesh was used in a clean or a potentially contaminated environment., Methods: Sixty male Wistar rats were randomly and equally allocated in 3 groups: A, B and C. Animals in all groups underwent laparotomy, a prosthetic mesh was placed and chemoprophylaxis with ciprofloxacin was administered. In groups B and C an enterectomy was also performed. NAC was injected intraperitoneally in group C. Adhesion formation, IL-1a, IL-6, TNF-a and histological data including fibrosis, neutrophils' infiltration and neovascularization were assessed. Mesh samples were sent for cultivation., Results: Adhesion formation was significantly less and inflammation markers were also lower in group C compared to group B (p<0.05). Histological findings were significant for greater fibrosis, neutrophils' infiltration and neovascularization in group B compared to both group A and C. Regarding mesh cultures, more specimens were tested positive in group B (p <0.05). Outcomes between group A and C did not differ., Conclusion: NAC effectively ameliorated adhesion formation and inflammation in a potentially septic environment where a prosthetic mesh was placed., Competing Interests: Declaration of competing interest None., (Copyright © 2021. Published by Elsevier B.V.)

Aim: Our goal was to investigate the potential use and efficacy of regorafenib for IPEC in an animal model of colorectal derived peritoneal metastases. Twenty four male rats were included. Carcinogenesis was induced in all rats through intraperitoneal injection of cancer., Material and Methods: Cells at T0. At T1(Day 28) they were randomly allocated 1:1:1:1 into 4 groups and underwent median laparotomy and the corresponding intervention. Specifically, Group A: no other intervention; Group B: cytoreductive surgery; Group C: intraperitoneal chemotherapy with regorafenib; and Group D: cytoreductive surgery and intraperitoneal chemotherapy with regorafenib. At T2 (Day 56) rats were euthanized and laparotomy was performed for further investigation. The primary outcome was the experimental Peritoneal Cancer Index (ePCI) at T2. Secondary outcomes include relative change of body weight between T1 and T2, weight of the ascites, anastomotic leak/peritonitis and death., Results: The ePCI was significantly lower in Group D as opposed to all other groups. Comparing Group C versus Group A we found a trend towards lesser tumor progression, but no significant difference. Growth of rats in Group D was significantly least affected compared to all other groups. Animals undergoing CRS in Group B developed less ascites than Group A and C. Less ascites was found in Group D compared to Group A and C., Conclusions: Intraperitoneal chemotherapy with regorafenib combined with cytoreductive surgery may impair metastases' progression., Key Words: Regorafenib, Chemotherapy, Cytoreductive surgery, Colorectal cancer, Intraperitoneal injection.

BACKGROUND Adrenocortical carcinomas are rare and aggressive tumors often diagnosed as incidentalomas. The malignancy can present with abnormal hormone secretion or the tumor may be non-functioning and present as a palpable mass causing discomfort. Here, we present a case of an adrenal cortical carcinoma originally identified as an incidentaloma. CASE REPORT A 63-year-old woman presented with abdominal pain and discomfort. A large abdominal mass, occupying the left upper and lower quadrant, was palpated. Imaging revealed a mass occupying the left abdomen between the stomach and the spleen, applying pressure on the pylorus, duodenum, splenic vessels, and pancreas. The mass size was 21.2×13×14.6 cm. Hormonal investigations were normal. Surgical exploration was performed, and the tumor was excised. Pathological analysis revealed an adrenocortical carcinoma and the patient underwent adjuvant chemotherapy. Twelve months later, the carcinoma recurred. The patient underwent a second operation in which the recurrent mass was excised along with the tail of the pancreas and a small part of the left lobe of the liver. The postoperative period was uneventful, and the patient was discharged home on the 7th postoperative day. No further adjuvant therapy was applied. The patient remains disease-free 18 months after the reoperation. CONCLUSIONS Giant adrenocortical carcinomas, although rare, pose a challenge to the surgical team both diagnostically and therapeutically. Surgical excision with the appropriate oncologic support can guarantee excellent outcomes.

Transdiaphragmatic intercostal hernia, in which the abdominal contents of the hernia protrude through the diaphragm and the thoracic wall defect. is a very rare type of hernia with only a few cases having been reported in the literature. That type of hernia is usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery. We present the case of a 60-year-old female admitted to the hospital after a car accident and suffered multiple rib fractures (6th, 7th, 8th right ribs / 7th, 8th, 9th left ribs), as well as flail thorax, hemothorax bilaterally, left subcutaneous emphysema and swelling of soft tissues of the right lateral thoracoabdominal wall. CT scan revealed herniation of hepatic parenchyma and intestinal loops into the thorax. The patient was treated surgically, and his postoperative course was uneventful. We also review the relevant literature concerning this transdiaphragmatic, intercostal hernia and identify 42 cases. Transdiaphragmatic intercostal hernia is a rare condition, usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery., Competing Interests: Conflict of interests: The authors declare no competing financial interests or conflicts of interest., (Copyright © 2021, Ioannidis O. et al., Applied Systems and Discoveries Journals.)

Background: One of the most challenging operations is the resection of the pancreas, which is associated with high morbidity. Metabolic control during the perioperative period remains an issue that is sometimes difficult to manage., Objectives: Exercise has a positive effect on glycaemic control. The objective of this trial was determining whether exercise has any benefit for oxidative stress and glucose levels., Method: The study was an open-label, randomised clinical trial. It has been registered in the International Standard Randomised Controlled Trial registry. The patients were selected according to the Consolidated Standard of Reporting Trials criteria., Results: In total, 56 patients were assessed for eligibility. There was no statistical difference between the 2 groups (the exercise and the control one) regarding the disease characteristics, morbidity or influence of exercise on oxidative stress; however, the control of glucose was superior in the exercise group., Conclusions: Exercise has a positive effect on glycaemic control in patients after pancreatic resection., (© 2019 S. Karger AG, Basel.)

The present study endeavors to investigate the attitudes, opinions and perceptions of livestock farmers regarding the main problems they face and confine the development of livestock in the Greek region of Evros. Primary data were collected through a quantitative survey (structured questionnaire) with livestock farmers in the region. The analysis of the survey data was carried out with the use of descriptive statistics, Friedman's test and factor analysis. The results indicate that strategies for livestock development in the region should take into account the great dissatisfaction that exists towards public authorities and the level of satisfaction as regards the non-governmental bodies. Furthermore, the economic objectives are of primary importance for livestock farmers, whereas they stress their interest in training and know-how. Particularly on issues pertaining to dairy livestock management, improving sanitation conditions and enhancing the quality, digestibility and production of animal feed.

1. The effects of dietary inclusion of red stigmas of Greek saffron (Crocus sativus L.) on the oxidative stability of shell eggs and liquid yolks were investigated and compared with those of dietary a-tocopherol. 2. Ninety-six Lohmann laying hens, 38 weeks old, distributed into 4 groups with 4 replicates each, were given either a control diet, diets enriched with 10 (SAF10) or 20 (SAF20) mg/kg saffron, or a diet enriched with 200 mg/kg a-tocopheryl acetate (VE200). 3. Following 6 weeks of feeding, eggs were collected and the rate of lipid oxidation was determined in refrigerated stored shell eggs, as well as in yolks adjusted to a pH of 6.2 or 4.2 and stored in the presence of light. 4. The results showed that the extent of lipid oxidation in shell eggs, as measured by malondialdehyde (MDA) formation, differed between dietary treatments, but did not change with storage time. In stored shell eggs, MDA levels differed between dietary treatments at all time points. 5. Yolks from the control group adjusted to pH 6.2 gave MDA values higher than those of the SAF10 group, which in turn were higher than those of the SAF20 group, a finding suggesting that saffron exerted a dose-dependent antioxidative activity. The VE200 group gave lower MDA values than the other groups at all time points. The oxidation profile of yolks at pH 4.2 showed a similar pattern but the rate of oxidation was greater.